Evidence map›Paper›PMID 41697979›Full record

ArticleCirculation2026

Hypertensive Disorders of Pregnancy and Premature Cardiovascular Disease in a Diverse Cohort of Young US Women.

Theresa M Boyer, Robert B Barrett, Christelle Xiong, Fan Bu, Rebekah A Bhansali, Amelia S Wallace, Michael Fang, Arthur Jason Vaught, Elizabeth Selvin, Allison G Hays and 3 more

Abstract read
In one paragraph

Article in Circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Theresa M BoyerDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0002-8071-9351
Robert B BarrettDivision of Biomedical Informatics and Data Science, Department of Medicine, (R.B.B., C.X.), Johns Hopkins University, Baltimore, MD.ORCID 0009-0001-1347-5246
Christelle XiongDivision of Biomedical Informatics and Data Science, Department of Medicine, (R.B.B., C.X.), Johns Hopkins University, Baltimore, MD.ORCID 0009-0001-0289-148X
Fan BuDepartment of Biostatistics, School of Public Health, University of Michigan, Ann Arbor (F.B.).ORCID 0000-0003-3697-1477
Rebekah A BhansaliSchool of Medicine, Johns Hopkins School of Nursing (R.A.B.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0002-8149-6583
Amelia S WallaceDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0002-1466-3791
Michael FangDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0003-2849-1780
Arthur Jason VaughtDivision of Maternal Fetal Medicine, Department of Gynecology and Obstetrics (A.J.V.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0002-2370-3716
Elizabeth SelvinDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0001-6923-7151
Allison G HaysDivision of Cardiology, Department of Medicine (A.G.H., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0003-2138-1589
Erin D MichosDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0002-5547-5084
Chiadi E NdumeleDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0002-1603-282X
Anum S MinhasDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health (T.M.B., A.S.W., M.F., E.S., E.D.M., C.E.N., A.S.M.), Johns Hopkins University, Baltimore, MD.ORCID 0000-0001-6680-0404

Funding

Johns Hopkins Training Program in Biomedical Informatics and Data ScienceT15LM013979 · NLM · JOHNS HOPKINS UNIVERSITY · PI CHRISTOPHER G CHUTE, Hadi Kharrazi · 2022 to 2026
$2.2M
Strength-Based Health Equity Across the Life CourseT32NR020315 · NINR · JOHNS HOPKINS UNIVERSITY · PI HAE-RA HAN · 2022 to 2026
$1.8M
Intersections of pre-pregnancy cardiometabolic risk factors, preeclampsia and cardiovascular disease in a lifecourse frameworkK23HL171886 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Anum Minhas · 2024 to 2026
$603k
NHLBI NIH HHS K23 HL171886NINR NIH HHS T32 NR020315NLM NIH HHS T15 LM013979
6 · The paper itself

Abstract

backgroundCardiovascular disease (CVD) prevalence is rising among younger women in the United States. Hypertensive disorders of pregnancy (HDP) are early indicators of cardiovascular risk, yet it remains unclear whether HDP independently increase CVD risk or reflect poor prepregnancy health. We aimed to quantify the association between HDP and incident CVD in a diverse, real-world population, with replication of findings across health systems.

methodsWe used data from the All of Us research program, encompassing >50 health systems across the United States, to identify women with longitudinal pregnancy and postpartum data (n=17 357; between 2007 and 2022). Multivariable Cox regression estimated adjusted hazard ratios (aHRs) of HDP with CVD (ischemic heart disease, heart failure, or stroke), overall and stratified by prepregnancy cardiometabolic risk factors (hypertension, obesity, diabetes, hyperlipidemia, or chronic kidney disease). Analyses were replicated in an independent health system (n=56 549; between 2016 and 2025) using the Observational Medical Outcomes Partnership Common Data Model.

resultsParticipants had a median [interquartile range] age of 30 [25, 35] years; 2719 (16%) identified as Black or African American, and 7267 (42%) identified as Hispanic or Latino. Among those who reported socioeconomic data, 4306 (35%) reported an income <$25 000, and 6429 (37%) a high school education at most. HDP occurred in 2098 (12%) of pregnancies. Over a median of 4.6 years of follow-up, 701 women developed CVD. Overall, HDP were associated with elevated CVD risk (aHR, 1.82 [95% CI, 1.49-2.22]). Regardless of prepregnancy cardiometabolic risk factors, HDP were independently associated with CVD risk (aHR, 2.06 [95% CI, 1.55-2.74] among women without risk factors, and aHR, 1.33 [95% CI, 1.00-1.77] among women with risk factors). Main findings showed similar effect estimates for the risk of HDP with composite CVD (aHR, 2.62 [95% CI, 2.17-3.16]) in the external replication cohort.

conclusionsIn a diverse, national sample of young US women, HDP were a significant marker of premature CVD risk, even in the absence of prepregnancy cardiometabolic risk factors. Integrating pregnancy complications into CVD risk stratification and promoting cardiometabolic health before, during, and after pregnancy may reduce the growing burden of early-onset CVD among women.

Indexed as

Cardiovascular DiseasesHypertension, Pregnancy-InducedAdultFemaleHumansIncidencePregnancyRisk FactorsUnited StatesYoung Adultcardiometabolic risk factorscardiovascular diseaseselectronic health recordshypertensionpopulation healthpreeclampsiapregnancypregnancy complications

Identifiers

PMID41697979
PMCPMC12912777

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.